Magnetic resonance cholangiopancreatography in malignant obstructive jaundice

Abstract

Objective Theaim of this study was to assess the role of magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of malignant biliary obstruction. Background MRCP is an established technique for the evaluation of intrahepatic and extrahepatic bile ducts in patients with known or suspected hepatobiliary disease. It is considered a reliable, noninvasive alternative to diagnostic endoscopic retrograde cholangiopancreatography. Patients and methods This study was conducted on 43 patients (28 male and 15 female) with malignant obstructive jaundice. Their ages ranged between 30 and 85 years with a mean age of 56.86 years. MRCP protocols applied for imaging of the hepatobiliary system were as follows: T2-weighted fast spin echo sequence on the axial and coronal planes; three-dimensional, fat suppressed, heavily T2-weighted fast spin echo sequence with multislab acquisition mode; two-dimensional thick single slab projectional images; and three-dimensional reconstruction algorithms. Results Among the patients, jaundice and biliary colic were the most common clinical complaints. MRCP detected different pathologic entities, including cholangiocarcinoma, hepatocellular carcinoma, pancreatic carcinoma, distal common bile duct stricture, periampullary carcinoma, gallbladder carcinoma, lymphoma, metastasis, and suprarenal carcinoma. The MRCP diagnosis was compared with the final diagnosis reached using histopathologic data, tumor marker, and follow-up imaging. Conclusion MRCP provides a safe, noninvasive, accurate diagnostic tool in the detection of the cause, level of biliary obstruction, and lymph node spread.